Parsonnet et al developed a model to predict operative mortality for adults having surgery for acquired adult heart disease. The model uses risk factors identified by multivariate analysis that were selected to be readily available in any hospital and objective. It was developed at the Beth Israel Medical Center in Newark, New Jersey, and tested at two other medical centers.
Risk Factor |
Finding |
Assigned Weight |
gender |
male |
0 |
|
female |
1 |
body weight |
morbid obesity (>= 1.5 times ideal weight) |
3 |
diabetes mellitus |
noninsulin and insulin dependent |
3 |
blood pressure |
hypertension, with systolic blood pressure > 140 mm Hg |
3 |
left ventricular ejection fraction |
good (>= 50%) |
0 |
|
fair (30 - 49%) |
2 |
|
poor (< 30%) |
4 |
age in years |
< 70 |
0 |
|
70 - 74 |
7 |
|
75 - 79 |
12 |
|
>= 80 |
20 |
reoperation |
first |
5 |
|
second |
10 |
preoperative intra-aortic balloon pump |
|
2 |
left ventricular aneurysm |
|
5 |
urgency of operation |
emergency surgery following PTCA or catheterization complication |
10 |
dialysis dependency |
peritoneal dialysis |
10 |
|
hemodialysis |
10 |
catastrophic states |
acute structural defect, cardiogenic shock, acute renal failure, other |
10 - 50 |
rare circumstances impacting cardiac surgery |
paraplegia, pacemaker dependency, congenital heart disease in an adult, severe asthma, other |
2 - 10 |
mitral valve surgery |
pulmonary artery pressure < 60 mm Hg |
5 |
|
pulmonary artery pressure >= 60 mm Hg |
8 |
aortic valve surgery |
pressure gradient <= 120 mm Hg |
5 |
|
pressure gradient > 120 mm Hg |
7 |
CABG done at the time of valve surgery |
|
2 |
after Table 2, page I5, Parsonnet (1989)
additive score =
= SUM(points for conditions present)
Interpretation:
• minimum score: 0
• maximum score: 148
Additive Score |
Risk Group |
Estimated Mortality Rate Within 30 Days of Surgery |
0 - 4 |
good |
1% |
5 - 9 |
fair |
5% |
10 - 14 |
poor |
9% |
15 - 19 |
high mortality |
17% |
>= 20 |
very high mortality |
31% |
after Figure 2, page I5, Parsonnet (1989)
Specialty: Cardiology, Surgery, general
ICD-10: ,